Get Texas Medicaid Provider Recoupment Form

All paper claims must be submitted with a Texas Provider Identifier (TPI) and National Provider Identifier (NPI) for the billing and performing providers. All other provider fields on the claim forms require an NPI only.

Short Answer: Medicaid patients are often responsible for out-of-pocket costs like copayments and spend-down deductibles, and you may be able to pay these amounts in cash if your care provider accepts it.

The Administrative Simplification Compliance Act (ASCA) requires that as of October 16, 2003, all initial Medicare claims be submitted electronically, except in limited situations. Medicare is prohibited from payment of claims submitted on a paper claim form that do not meet the limited exception criteria.

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. ... The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

Paper claim forms are encouraged only for services that require clinical documentation or other forms to process. Refer to the provider manual for instructions to submit paper claims.

(3) Claims from all other providers delivering services reimbursed by the Texas Medicaid acute care program must be received by HHSC or its designee within 95 days from each date of service on the claim or 95 days from the date the Texas Provider Identifier (TPI) Number is issued, whichever occurs later.

How to Enroll. Go to the Enrolling in the CSHCN Services Program page of the Texas Medicaid & Healthcare Partnership website. You can enroll online or print out the paper application form to complete and return to TMHP. If you have questions, call your local area TMHP provider relations representative.

To obtain a TPI number and THSteps enrollment, contact Texas Medicaid and Healthcare Partnership (TMHP) at 1-800-925-9126. ... NPI Number: Indicate the facility's 10-digit NPI number. All health care providers must use the National Provider Identifier (NPI) number.

Technically, there's no formal program or option that allows you to transfer your Medicaid coverage from one state to another. Therefore, if you're relocating, you'll need to reapply for Medicaid in the state you're planning to reside in.

Call toll-free at 800-252-8263, 2-1-1 or 877-541-7905. Choose English or Spanish. Choose option 2. The person you speak with can help you find out if you have Medicaid or not.